“The option that relieves the burden from your family”

One of the most loving, caring things that an individual can do is leave behind details and information in regards to Pre-Need. If you feel it is too hard to discuss funeral arrangements at this time just think how difficult it would be for your loved ones at a time of loss.

Advantages of Preplanning Your Funeral:

  • Preplanning will express your wishes.
  • Preplanning relieves your family from making difficult decisions at an emotional time.
  • Preplanning will give you and your family the security and satisfaction knowing that most or all of the arrangements have been planned and paid for.

Trying to plan the funeral of a loved one can be a very stressful and emotional time for any family. When someone close to us passes away, focusing on making funeral arrangements is very difficult. Preplanning a funeral can help ease this difficult time. Our caring funeral counselors can help make the preplanning process easy and affordable. By planning ahead, you can secure the cost of the funeral ahead of time, thus putting less burden on your family. When you talk to our Pre-Need Counselors, you are under no obligation. Our counselors are here to provide the information you will need to make your own decisions.
Personal Information
Name
(First MI Last):
Marital Status:   Social Security #:
Date of Birth: Place Of Birth:
Address:
City: State:
County: Zip:
Phone: E-mail:
Spouse's Name: Spouse's Maiden Name:
Place of
Marriage: 		Date of Marriage:
Father's Name: Mother's Name:
Mother's Maiden Name:
Person in Charge:
Address:
Phone:
Physician's Name:

Work/Education History
Education (0-12):
 College 1-5+:
Occupation:
Industry:
 Employer:
Schools Attended and Graduation Years

Military Record
Branch of Service: Serial Number:
Date Enlisted: Rank At Discharge:
Date Discharged: Discharge On File At:
Copy of Discharge Papers:     Yes     No
Name Of Wars:


Funeral Service Request
Place Of Service:
Length of Visitation:
Hours of Visitation:
Religious Denomination:
Place Of Worship:


Newspaper Information (Please list family members)
Spouse:
Parents:
Children:
Brothers/Sisters:
Grandchildren:
Great Grandchildren:
List any other significant relatives :


Special Instructions
Lodges, Organizations, Unions, and Offices held:
Jewelry:
Glasses:
Person in Charge of Final Arrangements:
Clothing Preference: My own Other
Funeral Luncheon Site:

Disposition Request
I Prefer:
Cemetery:
Address: Phone:
Section:
Lot #:
Grave #:

If cremation, final disposition of cremated remains should be?
Burial Location:
Scattering Location:


Other Instructions

Memorials/Donations To Charity

Please select all that apply:
Send information about pre-arrangement

Contact me to set an appointment

Please keep my information on file


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